Indian physiotherapists’ perceptions of factors that influence the adherence of Indian patients to physiotherapy treatment recommendations

Background: Non-adherence to treatment is common and costly. Outside western culture little is known about the reasons for non-adherence with physiotherapy. This qualitative, grounded theory, focus group study investigated physiotherapists' perception of the factors affecting non-adherence of patients to physiotherapy treatment in India. Method: Six practising physiotherapists from New Delhi, India, formed a focus group and were invited to discuss their views regarding factors influencing patient non-adherence and their strategies to cope with these factors. The dialogue was transcribed and analysed. Significant statements/ words describing non-adherence were identified and clusters of meaning developed and used to write a composite, thematic description presenting the essence of the discussion. Results: The major factors identified were: poor awareness of physiotherapy and poor infrastructure, time, economic factors, social and cultural factors and poor communication. Patient and family education formed the basis for many of the strategies identified by physiotherapist to help them manage non-adherence. Conclusion: Physiotherapists in India recognise some barriers to adherence and have strategies that they perceive as helpful in encouraging motivation that are unique to the Indian social context. Other barriers to adherence and strategies recognised as key to improving adherence in western countries were not recognised by this group.